Health eCareers on MSN

Why the most influential NP roles are no longer bedside-centered

The majority of nurse practitioner (NP) roles primarily focus on direct patient care. However, did you know that there are ...

MCG and Loma Linda University Health to Highlight AI-Driven Advances in Utilization and Case Management at ACMA 2026

MCG Health, part of the Hearst Health network and the industry's source of truth for trusted clinical guidance, announces that its Director ...
Becker's Hospital Review

Breaking the cycle: How leveraging love, process redesign enhanced utilization management and elevated patient care

Health systems and health insurance plans spend enormous sums of money battling over how to be paid fairly — and these battles have only intensified with the growth of Medicare Advantage plans, which ...
HealthLeaders Media

The Exec: How to Succeed in Utilization Management

Jill O'Brien, Morton Hospital's new CMO, says the essence of utilization management is providing the right care for the right patient in the right setting at the right time. The new CMO of Morton ...
The American Journal of Managed Care

Association of Care Management Intensity With Healthcare Utilization in an All-Condition Care Management Program

Higher intensity of care management in an all-condition program addressing care coordination and care barriers was associated with increased healthcare utilization among Medicaid and Medicare patients ...
Business Wire

Sagility Introduces Utilization Management as a Service to Improve Prior Authorization, Mitigate Costs

DENVER--(BUSINESS WIRE)--Sagility, LLC, a technology-enabled healthcare business process management (BPM) company, has announced the launch of its Utilization Management as a Service (UMaaS) offering ...
The American Journal of Managed Care

Patient-centered Management of Complex Patients Can Reduce Costs Without Shortening Life

Objective:To determine the effect of intensive patient-centered management (PCM) on service utilization and survival. Study Design: Prospective cohort study of 756 patients in California who had a ...
Becker's Hospital Review

Nuts and Bolts of ACO Financial and Operational Success: Calculating and Managing to Actuarial Utilization Targets

Whether an ACO enters into a shared savings or capitation arrangement, its financial success will depend on delivering and managing care that meets or beats the established actuarial budget. For ACO ...
Financial Post

Sagility Introduces Utilization Management as a Service to Improve Prior Authorization, Mitigate Costs

Utilization management (UM) and prior authorization, which is the most commonly practiced form of utilization management, are both highly regulated, and health plans can face high penalties and fines ...